Section 1557 of the Affordable Care Act mandates nondiscrimination in health care programs managed or funded by the Department of Health and Human Services (HHS), with upcoming deadlines for compliance set for May and July...more
4/18/2025
/ Affordable Care Act ,
Biden Administration ,
Department of Health and Human Services (HHS) ,
Discrimination ,
Executive Orders ,
Filing Deadlines ,
Foreign Language ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
LGBTQ ,
Medicare ,
Medicare Part B ,
Regulatory Requirements ,
Section 1557 ,
Trump Administration
On January 6, 2025, the U.S. Department of Health and Human Services (“HHS”) Office for Civil Rights (“OCR”) published a Notice of Proposed Rulemaking (“NPRM”) to amend the Health Insurance Portability and Accountability Act...more
1/14/2025
/ Comment Period ,
Cybersecurity ,
Data Privacy ,
Data Security ,
Department of Health and Human Services (HHS) ,
Electronic Protected Health Information (ePHI) ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
HIPAA Security Rule ,
NPRM ,
OCR ,
Patient Privacy Rights ,
Public Comment ,
Regulatory Agenda ,
Regulatory Reform ,
Risk Management
The Departments of the Treasury, Labor, and Health and Human Services have published final regulations under the Mental Health Parity and Addiction Equity Act that prohibit group health plans and health insurers from imposing...more
10/15/2024
/ Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Final Rules ,
Health and Welfare Plans ,
Health Insurance ,
Healthcare Reform ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
NQTLs ,
U.S. Treasury
Following the U.S. Supreme Court’s recent decision to overturn its landmark 1984 Chevron decision, three district courts have struck down provisions in nondiscrimination regulations under the Affordable Care Act that prohibit...more
8/1/2024
/ Affordable Care Act ,
Biden Administration ,
Chevron Deference ,
Civil Rights Act ,
Department of Health and Human Services (HHS) ,
Employee Benefits ,
Gender Identity ,
Health Insurance ,
LGBTQ ,
Loper Bright Enterprises v Raimondo ,
New Regulations ,
Non-Discrimination Rules ,
Preliminary Injunctions ,
SCOTUS ,
Sex Discrimination ,
Statute of Limitations ,
Statutory Interpretation ,
Title IX
Over the course of the past few months, the Office of Civil Rights (OCR) and the Office of the National Coordinator for Health Information Technology (ONC), both of which are divisions of the U.S. Department of Health and...more
6/28/2024
/ Cyber Attacks ,
Cybersecurity ,
Data Breach ,
Department of Health and Human Services (HHS) ,
Electronic Medical Records ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
HIPAA Breach ,
Information Technology ,
OCR ,
ONC ,
Personally Identifiable Information ,
PHI ,
Reproductive Healthcare Issues
The U.S. Department of Health and Human Services (HHS) has issued final regulations on the nondiscrimination rules set forth in Section 1557 of the Affordable Care Act. The new rules apply to certain group health plans, as...more
6/19/2024
/ Affordable Care Act ,
Department of Health and Human Services (HHS) ,
Employee Benefits ,
Employees ,
Employer Liability Issues ,
Health Insurance ,
Health Plan Sponsors ,
Healthcare ,
Medicare ,
New Rules ,
Proposed Rules ,
Sex Discrimination
You are the HIPAA privacy official of a hospital or health plan (a covered entity under HIPAA). You receive an email from a vendor that handles protected health information (a business associate), informing you that one month...more
1/5/2024
/ Cybersecurity ,
Data Breach ,
Data Privacy ,
Data Protection ,
Data Security ,
Department of Health and Human Services (HHS) ,
Electronic Medical Records ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Personally Identifiable Information
The United States Department of Health and Human Services (HHS) has filed court pleadings stating that it does not intend to initiate enforcement actions against plans that maintain copay accumulator programs....more
12/11/2023
/ Affordable Care Act ,
Co-payments ,
Department of Health and Human Services (HHS) ,
Employee Benefits ,
Employees ,
Employer Group Health Plans ,
Enforcement Guidance ,
Final Rules ,
Health Insurance ,
Healthcare ,
Non-Enforcement ,
Pharmaceutical Industry ,
Prescription Drugs ,
Rulemaking Process
Summary -
Employers taking advantage of copay accumulator programs now face unexpected administrative complications following a recent federal court decision....more
10/18/2023
/ Affordable Care Act ,
Benefit Plan Sponsors ,
Co-payments ,
Cost-Sharing ,
Department of Health and Human Services (HHS) ,
Employee Benefits ,
Employees ,
Health Insurance ,
Out-of-Pocket Expenses ,
Prescription Drug Coverage ,
Prescription Drugs ,
Subsidies ,
Third-Party
Summary -
The Departments of Labor, Health and Human Services, and the Treasury have proposed regulations under the Mental Health Parity Act that build on prior guidance to set forth requirements for an extremely detailed...more
8/16/2023
/ Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Health Insurance ,
Healthcare ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
NQTLs ,
Proposed Regulation ,
Proposed Rules ,
U.S. Treasury
Summary -
On July 25, 2023, the Departments of Labor, Treasury, and Health & Human Services (the Departments) released joint proposed regulations and other guidance under the Paul Wellstone and Pete Domenici Mental Health...more
8/1/2023
/ Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Health Insurance ,
Healthcare ,
Mental Health ,
Mental Health Parity Rule ,
MHPAEA ,
NQTLs ,
Proposed Regulation ,
Proposed Rules ,
U.S. Treasury
Summary -
By December 31, 2023, health plans and insurers must submit an attestation of compliance with the anti-gag rules of the Consolidated Appropriations Act, 2021 (CAA). The rules apply to all agreements entered into...more
7/21/2023
/ Attestation Deadlines ,
Consolidated Appropriations Act (CAA) ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Gag Clauses ,
Health Care Providers ,
Health Insurance ,
HRA ,
Internal Revenue Code (IRC) ,
U.S. Treasury
The Departments of Labor, Health and Human Services, and the Treasury have published a set of proposed rules that impose new limits on two types of benefits: short-term limited-duration insurance (STLDI) and fixed indemnity...more
Summary -
The Departments of Labor, Health and Human Services, and the Treasury have issued guidance that coordinates application of the No Surprise Billing rules under the Consolidated Appropriations Act, 2021, with the...more
Summary -
The Departments of Labor, the Treasury, and Health and Human Services have jointly issued FAQs that address the requirement to cover the full cost of certain preventive care services in view of the recent ruling...more
4/19/2023
/ Advisory Committee ,
Affordable Care Act ,
Biden Administration ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Department of Labor (DOL) ,
Employee Benefits ,
Health Insurance ,
Healthcare ,
HRSA ,
New Guidance ,
Preventive Health Care
Summary -
Health plans and insurance policies may no longer be required to cover the full cost of preventive care that carries an A or B rating by the U.S. Preventive Services Task Force (USPSTF), following a recent ruling...more
Summary -
The Departments of Labor, Health and Human Services, and the Treasury have issued guidance on how health plans and insurers may attest to their compliance with the anti-gag rules of the Consolidated...more
In a new set of Frequently Asked Questions, the U.S. Departments of Labor, Health and Human Services, and the Treasury provide significant relief to health plan sponsors and insurers seeking to report on expenditures for...more
Summary -
The Department of Health and Human Services (HHS) has issued proposed regulations under the nondiscrimination provisions of Section 1557 of the Affordable Care Act (ACA). The proposed rules restore and augment a...more
On April 19, 2022, the U.S. Departments of Health and Humans Services, Labor, and Treasury (collectively, the Departments) issued guidance which sets forth two separate safe harbors for group health plans and health insurance...more
Summary -
The Consolidated Appropriations Act, 2021 (CAA) requires group health plans and health insurers to submit information regarding the costs of prescription drug costs and other health care services each year to the...more
Summary -
The Consolidated Appropriations Act (CAA) requires each group health plan and health insurer with a network of providers to maintain a database on a public website that lists the name, address, specialty,...more
Summary -
To help individuals better understand the costs they will bear for medical care, the Consolidated Appropriations Act (CAA) requires health plan ID cards to include clear information about deductibles and...more
Summary -
New rules require group health plans and insurers to disclose pricing information in three phases. This is the third briefing in Ballard Spahr’s series on the Consolidated Appropriations Act, 2021 (CAA) and...more
Revisions to preventive care and screening guidelines will require health plans and health insurance policies to provide 100 percent coverage for additional services for women, adolescents, children, and infants, following an...more